Drug delivery systems to prevent peritoneal metastasis after surgery of digestives or ovarian carcinoma: A review.

Peritoneum represents a frequent site of metastasis especially for digestive and ovarian primary cancers. The conventional approach to treat peritoneal metastasis consists in systemic chemotherapy, but the median survival associated is only a few months. Recent therapeutic developments result in an aggressive strategy associating cytoreductive surgery (CRS) and hyperthermic intra peritoneal chemotherapy (HIPEC). However, a recent study failed to show an improvement in the overall survival and relapse free survival of this combo in comparison to CRS alone. Confronted to a lack of guidelines, several drug delivery systems (DDS) had been developed and tested in animal models to offer an effective easy-to-use solution for surgeons to prevent peritoneal metastasis. In this work, we reviewed most of the strategies used to treat peritoneal metastasis (PM) from digestive or ovarian origin and concentrated on 3 different DDS strategies: particulates DDS, non particulates DDS (including implants, films and gels) and combination of both (in particular hydrogels loaded with particles).